| NPI | 1659349215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 044251) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY C4227) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2025-12-15 |